Ecological Momentary Intervention for Reward in Anhedonia
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 60
- 试验地点
- 1
- 主要终点
- Change in anhedonia/hedonic capacity; measured with the Snaith-Hamilton Pleasure Scale (SHAPS) from baseline to post-intervention and baseline to 3-months follow-up
研究概览
简要总结
The present study evaluates a two week ecological momentary intervention (EMI) in reducing anhedonia and psychological distress (i.e. elevated depression, stress and anxiety). Participants in the experimental group complete three daily exercises targeting reward-related processes, including positive mental imagery, savoring, gratitude, taking ownership for positive experience, and silver lining. These components were selected to improve reward anticipation as well as reward consumption and reward learning as the underlying mechanisms of anhedonia. An active control group receives progressive muscle relaxation training, matched in format and frequency. Exercise units are presented using audio recordings via smartphone app.
详细描述
Anhedonia, the diminished ability to experience positive emotions such as pleasure, is a clinically relevant condition central to depression and frequently observed across a range of other psychological disorders including anxiety disorders or chronic stress. Despite its prevalence and impact on quality of life, effective interventions specifically targeting anhedonia remain limited. Standard cognitive-behavioral therapies (CBT) often reduce negative affect (e.g., sadness, anxiety) but tend to be less effective in enhancing positive affect. Moreover, anhedonia has been proposed as a potential limiting factor in the efficacy of exposure-based treatments for anxiety disorders, underscoring the need for low-threshold interventions that directly target reward-related deficits.
At the core of anhedonia lies impaired reward processing, which involves multiple phases: (1) reward anticipation (wanting), (2) reward consumption (liking), and (3) reward-based learning. Individuals with elevated anhedonia often show deficits across these domains, leading to reduced engagement in rewarding activities and motivational impairments. Therefore, effective interventions should aim to strengthen these specific facets of reward functioning.
Emerging approaches such as Positive Affect Treatment (PAT) have demonstrated promising effects by combining components like positive mental imagery, savoring, self-reinforcement (i.e., taking ownership of positive experiences), and cognitive reframing (e.g., silver lining techniques). Complementary evidence suggests that gratitude-based interventions can enhance well-being and buffer against stress, based on the idea that gratitude and negative affect are partially incompatible.
Building on these findings, the current study tests a two-week ecological momentary intervention (EMI) designed to enhance reward processing and reduce anhedonia in daily life. The intervention is delivered via the smartphone app m-Path and comprises three brief training units per day. These include a combination of audio-guided exercises and ecological momentary assessments (EMA) capturing mood, activity, and psychological symptoms. The exercises target positive mental imagery, savoring, gratitude, silver lining, and taking ownership of positive experiences-each mapped onto distinct components of reward processing. EMI formats offer the advantage of flexibility and integration into everyday contexts without requiring direct clinician contact.
Participants are randomly assigned to either the reward-focused intervention group or an active control group. The control group receives a structurally equivalent two-week training consisting of progressive muscle relaxation (PMR) exercises, also delivered via the m-Path app. PMR is an established stress-reduction technique and serves as an active comparator matched in format, frequency, and duration. The control group completes two audio-guided PMR sessions per day and one brief reflection unit each evening.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Participant)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •German speaking
- •Smartphone available and willingness to participate in repeated training units and questions delivered via app
- •Clinically elevated anhedonia (SHAPS >= 25) and elevated depression (DASS-21-Depression >= 10), elevated anxiey (DASS-21-Anxiety >= 6) or elevated stress (DASS-21-Stress >= 10)
排除标准
- •Psychotropic medication
- •Psychotherapy currently ongoing or planned during participation
- •Suicidality, lifetime diagnosis of bipolar disorders or psychotic episodes
研究组 & 干预措施
Reward Training
干预措施: Training of reward processing/sensitivity (Behavioral)
Reward Training
干预措施: Psychoeducation (Other)
Relaxation Training
干预措施: Relaxation Training (PMR) (Behavioral)
Relaxation Training
干预措施: Psychoeducation (Other)
结局指标
主要结局
Change in anhedonia/hedonic capacity; measured with the Snaith-Hamilton Pleasure Scale (SHAPS) from baseline to post-intervention and baseline to 3-months follow-up
时间窗: Baseline, 2 weeks (completion of intervention) and 3 months
The scale consists of 14 items rated on a four-point Likert-scale (1 = "I completely agree", 2 = "I agree", 3 = "I do not agree", 4 = "I completely disagree"). The SHAPS assesses participants' hedonic capacity/ability to feel pleasure. Sum scores range from 14 to 56, with a higher scores indicating more pronounced anhedonia. The scale is a standard survey method for anhedonia and has been validated by a large number of studies.
Change in depression, anxiety and stress; measured with the Depression-Anxiety-Stress-Scale (DASS-21) from baseline to completion and baseline to follow-up
时间窗: Baseline, 2 weeks (completion of intervention) and 3 months
The questionnaire consists of 21 items rated on a four-point Likert-scale (0 = "Didn't apply to me at all", 1 = "Applied to me to a certain extent or sometimes", 2 = "Applied to me to a considerable extent or quite often", 3 = "Applied very strongly to me, or most of the time"). The questionnaire is used to assess the severity of depressive, and anxiety symptoms as well as symptoms of distress during the last week. Scores range from 0 to 63 with the overall score being an indicator of general psychopathology. Subscales for depression, anxiety and stress exist. The scale is a widely used survey method and has proven to be a valid measure many times.
次要结局
- Change in anhedonia; measured with the Dimensional Anhedonia Rating Scale (DARS) from baseline to completion and baseline to follow-up(Baseline, 2 weeks (completion of intervention) and 3 months)
- Change in reward sensitivity and procession; measured with the Positive Valence System Scale-21 (PVSS-21) from baseline to completion and baseline to follow-up(Baseline, 2 weeks (completion of intervention) and 3 months)
- Trait-Positive Emotionality (PE) and its change as measured with the NEO-Five-Factor (NEO-FFI) Positive-Emotionality-Subscale from baseline to completion and baseline to follow-up(Baseline, 2 weeks (completion of intervention) and 3 months)
- Positive and negative affect and their changes; measured with the Positive and Negative Affect Schedule (PANAS) from baseline to completion and baseline to follow-up(Baseline, 2 weeks (completion of intervention) and 3 months)
- Change in social anxiety; measured with the Social Phobia Inventory (SPIN) from baseline to completion and baseline to follow-up(Baseline, 2 weeks (completion of intervention) and 3 months)
- Change in social anxiety; measured with the Social Interaction Anxiety Scale (SIAS) from baseline to completion and baseline to follow-up(Baseline, 2 weeks (completion of intervention) and 3 months)
- Imagination abilities; measured with the Spontaneous Use of Imagery Scale (SUIS) from baseline to completion and baseline to follow-up(Baseline, 2 weeks (completion of intervention) and 3 months)
- Changes in use of emotion regulation strategies; measured with the Emotion Regulation Questionnaire (ERQ) from baseline to completion and baseline to follow-up(Baseline, 2 weeks (completion of intervention) and 3 months)
- Vividness of mental images; measured with the Plymouth Sensory Imagery Questionnaire (PSI-Q) from baseline to completion and baseline to follow-up(Baseline, 2 weeks (completion of intervention) and 3 months)
- Changes in feeling gratitude; measured with the Gratitude Questionnaire-Five-German (GQ-5-G) from baseline to completion and baseline to follow-up(Baseline, 2 weeks (completion of intervention) and 3 months)
- Changes in perseverative thinking; measured with the Perseverative Thinking Questionnaire (PTQ) from baseline to completion and baseline to follow-up(Baseline, 2 weeks (completion of intervention) and 3 months)
- Changes in feeling overall relaxed (single self-composed visual analog scale item) from baseline to completion and baseline to follow-up(Baseline, 2 weeks (completion of intervention) and 3 months)
- Changes in feeling stressed; measured with the Perceived Stress Questionnaire (PSQ) from baseline to completion and baseline to follow-up(Baseline, 2 weeks (completion of intervention) and 3 months)
- Changes in general well-being; measured with the Short Form-8 Health Survey (SF-8-HS) from baseline to completion and baseline to follow-up(Baseline, 2 weeks (completion of intervention) and 3 months)
- EMA-measures during active participation (part 2)(Three times daily (morning, afternoon, evening; accompanying the exercises) over he course of 14 days)
- Unwanted effects of the intervention/negative intervention outcomes; measured with the Inventory for balanced recording of negative effects of psychotherapy (INEP)(3 months)
- EMA-measures during active participation (part 1)(Three times daily (morning, afternoon, evening; accompanying the exercises) over the course of 14 days)
- EMA-measures during active participation (part 3)(Three times daily (morning, afternoon, evening; accompanying the exercises) over the course of 14 days)
研究者
Christoph Benke
Principal Investigator
Philipps University Marburg